不同方案治疗脑胶质母细胞瘤患者的生存分析  

Survival analysis of patients with glioblastoma treated with different treatment schemes

作　　者：王孔成[1] 刘娟[1] 倪红斌[2] 闫婧[1] 陈维涛[1] 黄斌[1] WANG Kongcheng;LIU Juan;NI Hongbin;YAN Jin;CHEN Weitao;HUANG Bin(The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院肿瘤中心,南京210008 [2]南京大学医学院附属鼓楼医院神经外科,210008

出　　处：《临床肿瘤学杂志》2022年第2期133-137,共5页Chinese Clinical Oncology

摘　　要：目的探讨不同治疗方案对脑胶质母细胞瘤患者生存的影响。方法回顾性分析2018年3月至2020年7月南京鼓楼医院肿瘤科收治的67例脑胶质母细胞瘤患者的临床资料。按治疗方案分组,同步加量组(32例)为采用替莫唑胺辅助化疗序贯同步加量调强放疗及同步替莫唑胺化疗、序贯替莫唑胺辅助化疗的患者;常规治疗组(35例)采用术后放疗联合替莫唑胺同步并辅助化疗的患者。比较不同治疗患者的临床资料和不良反应。采用Kaplan-Meier法绘制生存曲线,生存差异行Log-rank检验。结果两组患者的年龄、性别、肿瘤部位、分子病理结果、治疗前Karnofsky功能状态评分(KPS)差异均无统计学意义(P>0.05)。同步加量组2年生存率为75.0%,常规治疗组2年生存率为0%。同步加量组未到达中位生存时间,常规治疗组中位生存时间为14.6个月(12.07~18.07个月),同步加量组的总体生存率高于常规治疗组(P<0.05)。两组患者的血液学、中枢神经系统、消化道、皮肤等不良反应大多数在0~1级,少数2级,差异无统计学意义(P>0.05)。结论采用替莫唑胺辅助化疗序贯同步加量调强放疗及同步替莫唑胺化疗、序贯替莫唑胺辅助化疗的治疗新模式,可以有效地延长脑胶质母细胞瘤患者的生存期,不良反应可以耐受。Objective To investigate the effect of different treatment schemes on the survival of patients with glioblastoma.Methods The clinical data of 67 patients with glioblastoma treated in the oncology department of Nanjing Drum Tower Hospital Hospital from March 2018 to July 2020 were analyzed retrospectively.According to the treatment scheme,the synchronous dose group(32 cases)were patients treated with temozolomide adjuvant chemotherapy,sequential synchronous dose intensity modulated radiotherapy,synchronous temozolomide chemotherapy and sequential temozolomide adjuvant chemotherapy,and the routine treatment group(35 cases)were patients treated with postoperative radiotherapy combined with temozolomide concurrent and adjuvant chemotherapy.The clinical data and adverse reactions of patients with different treatments were compared.The survival curve was drawn by Kaplan-Meier method,and the survival difference was tested by Log-rank test.Results There was no significant difference in age,sex,tumor location,molecular pathological results and Karnofsky functional state score(KPS)between the two groups(P>0.05).The 2-year survival rate was 75.0%in the synchronous dose group and 0%in the routine treatment group.The median survival time of the synchronous dosing group was not reached.The median survival time of the conventional treatment group was 14.6 months(12.07-18.07 months).The overall survival rate of the synchronous dosing group was higher than that of the conventional treatment group(P<0.05).Most of the adverse reactions of hematology,central nervous system,digestive tract and skin in the two groups were grade 0-1,and a few were grade 2.The difference was not statistically significant(P>0.05).Conclusion The new treatment mode of temozolomide adjuvant chemotherapy,sequential simultaneous dose-modulated radiotherapy,synchronous temozolomide chemotherapy and sequential temozolomide adjuvant chemotherapy can effectively prolong the survival time of patients with glioblastoma,and the adverse reactions can be tolerated.

关 键 词：脑胶质母细胞瘤 替莫唑胺 辅助化疗 同步加量调强放疗 

分 类 号：R739.41[医药卫生—肿瘤]